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1. HIV pre-exposure prophylaxis for men who have sex with men in west Africa: a multicountry demonstration study

Author

Christian Laurent, Bintou Dembélé Keita, Issifou Yaya, Gwenvael Le Guicher, Luis Sagaon-Teyssier, Mawuényégan K Agboyibor, Alou Coulibaly, Issa Traoré, Jean-Baptiste Malan, Irith De Baetselier, August Eubanks, Lucas Riegel, Daniela Rojas Castro, Hortense Fayé-Ketté, Amadou Koné, Souba Diandé, Claver A Dagnra, Laetitia Serrano, Fodié Diallo, Ephrem Mensah, Ter Tiero E Dah, Camille Anoma, Bea Vuylsteke, Bruno Spire, Sayouba Ouedraogo, Bruno Granouillac, Martine Peeters, Clotilde Couderc, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Paméla Palvadeau, Thijs Reyniers, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Ekissi Jean Armel Koffi, Dibi Frédéric N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Dagnra, Kokou Dominique Tegueni, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), ARCAD Santé PLUS [Bamako, Mali], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Espoir Vie Togo [Lomé, Togo], Association African Solidarité [Ouagadougou, Burkina Faso], Espace Confiance [Abidjan, Côte d’Ivoire], Institute of Tropical Medicine [Antwerp] (ITM), Coalition PLUS [Pantin, France], Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), Université des sciences, des techniques et des technologies de Bamako (USTTB), Laboratoire National de Référence de la Tuberculose [Ouagadougou, Burkina Faso] (LNRT), Laboratoire National de Référence de la tuberculose [Lomé, Togo] (LNRT/CHU Lomé), CohMSM-PrEP Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bea Vuylsteke, Irith De Baetselier, Thijs Reyniers, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Jean-Baptiste Malan, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Ekissi Jean Armel Koffi, Dibi Frédéric N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Dagnra, Kokou Dominique Tegueni, Malbec, Odile, Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)

Subjects
Adult, Male, 0301 basic medicine, Anti-HIV Agents, Epidemiology, Sexual Behavior, [SDV]Life Sciences [q-bio], Immunology, HIV Infections, Pilot Projects, Emtricitabine, Men who have sex with men, West africa, Young Adult, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, Virology, parasitic diseases, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Dosing, Homosexuality, Male, Tenofovir, Prospective cohort study, business.industry, 1. No poverty, 030112 virology, 3. Good health, [SDV] Life Sciences [q-bio], Africa, Western, Regimen, Infectious Diseases, Cohort, Pre-Exposure Prophylaxis, business, Demography, medicine.drug
Abstract

International audience; Background HIV pre-exposure prophylaxis (PrEP) data in men who have sex with men (MSM) in west Africa are essential to guide its large-scale implementation. We assessed the uptake of event-driven and daily PrEP, HIV incidence, and changes over time in sexual behaviours and prevalence of bacterial sexually transmitted infections (STIs) in MSM in Burkina Faso, Côte d'Ivoire, Mali, and Togo. Methods We did a prospective cohort study from Nov 20, 2017, to April 14, 2020, in four community-based clinics in Abidjan (Côte d'Ivoire), Bamako (Mali), Lomé (Togo), and Ouagadougou (Burkina Faso). Participants were MSM aged 18 years or older at substantial risk of HIV infection. Participants could choose between event-driven (2+1+1 dosing) and daily oral PrEP (tenofovir disoproxil fumarate 300 mg plus emtricitabine 200 mg), switch regimen, and discontinue or restart PrEP. We compared HIV incidence in this study with that of the same cohort before the availability of PrEP (CohMSM). Statistical analysis included the Kaplan-Meier method and mixed-effects regression models. This study is registered with ClinicalTrials.gov, NCT03459157. Findings We followed up 598 participants for a total of 743•6 person-years. At enrolment, 445 (74%) of 598 participants chose event-driven PrEP and 153 (26%) of 598 chose daily PrEP. 60 (13%) of 445 and 65 (42%) of 153 partici pants switched PrEP regimen at least once (p

Published
2021
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2. Combined Sexual Behavioral Profiles in HIV-Seronegative Men Who have Sex with Men in West Africa (CohMSM ANRS 12324-Expertise France)

Author

Pierre-Julien, Coulaud, Luis, Sagaon-Teyssier, Mohamed, Mimi, Bakridine, M'madi Mrenda, Gwenaëlle, Maradan, Marion, Mora, Michel, Bourrelly, Bintou Dembélé, Keita, Abdoul Aziz, Keita, Camille, Anoma, Stéphane-Alain, Babo Yoro, Ter Tiero Elias, Dah, Christian, Coulibaly, Ephrem, Mensah, Selom, Agbomadji, Adeline, Bernier, Clotilde, Couderc, Christian, Laurent, Bruno, Spire, Claver Anoumou Yaotsè, Dagnra, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), ARCAD-SIDA [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Coalition PLUS [Pantin, France], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), CohMSM Study Group: Clotilde Couderc, Bruno Granouillac, Suzanne Izard, Christian Laurent, Laura March, Martine Peeters, Laetitia Serrano, Cyril Berenger, Michel Bourrelly, Pierre-Julien Coulaud, Gwenaëlle Maradan, Bakri M'madi Mrenda, Marion Mora, Enzo Parisi, Luis Sagaon-Teyssier, Bruno Spire, Adeline Bernier, Paméla Palvadeau, Daniela Rojas Castro, Drissa Camara, Oumar Cisse, Alou Coulibaly, Bintou Dembele Keita, Fodié Diallo, Mahamadou Diarra, Mady Gadjigo, Abdoul Aziz Keita, Kader Maiga, Aly Ouologuem, Fodé Traore, Niamkey Thomas Aka, Camille Anoma, Stéphane-Alain Babo Yoro, Noufo Hamed Coulibaly, Rachelle Kotchi, Patrick Kouabenan, Malan Jean-Baptiste Kouame, Kpassou Julien Lokrou, Frédéric Dibi N'Guessan, Xavier Anglaret, Jean-Marie Masumbuko, Maxime Oga, Christian Coulibaly, Ter Tiero Elias Dah, Ousseni Ilboudo, Joseph Ouedraogo, Mamadou Ouedraogo, Elisabeth Thio, Juste Rodrigue Toure, Abdoulazziz Traore, Issa Traore, Fiffou Yougbare, Nicolas Meda, Kouakou Kokouvi Selom Agbomadji, Richard Mawuényégan Kouamivi Agboyibor, Messan Attiogbe, Aléda Mawuli Badjassim, Agbégnigan Lorette Ekon, Anouwarsadat Kokouba, Ephrem Mensah, Diimiln Joseph Strauss Tablissi, Kossi Jeff Yaka, Claver Anoumou Yaotsè Dagnra, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Dupuis, Christine

Subjects
Male, Sexual behavior, [SDV]Life Sciences [q-bio], HIV risk, Human immunodeficiency virus (HIV), HIV Infections, Human sexuality, medicine.disease_cause, West africa, Men who have sex with men, Cohort Studies, Sexual and Gender Minorities, 0302 clinical medicine, MESH: Sexual Partners, 030212 general & internal medicine, 10. No inequality, MESH: Cohort Studies, General Psychology, virus diseases, MESH: HIV Infections, 3. Good health, [SDV] Life Sciences [q-bio], MESH: Sexual and Gender Minorities, Africa, Western, Sexual Partners, MESH: Risk-Taking, MESH: Young Adult, Cohort, Sexual orientation, 0305 other medical science, Psychology, Adult, medicine.medical_specialty, MESH: Homosexuality, Male, Young Adult, 03 medical and health sciences, Risk-Taking, Arts and Humanities (miscellaneous), Identity, MESH: Africa, Western, West Africa, medicine, Humans, MSM, Homosexuality, Male, MESH: Humans, 030505 public health, Public health, MESH: Adult, MESH: Male, Demography
Abstract

International audience; Understanding the dynamics of HIV infection in men who have sex with men (MSM) can help improve efficiency in existing prevention strategies. We aimed to identify and describe the sexual behaviors of MSM most at risk of HIV infection in West Africa. HIV-negative MSM were provided a quarterly preventive follow-up package in the community-based cohort CohMSM. They completed face-to-face sociobehavioral questionnaires every 6 months. This sub-study on 520 participants used a baseline, 6-, 12- and 18-month data cluster analysis to categorize two profiles (high risk [HRE] and moderate risk [MRE] of exposure to HIV) based on three risky sexual practices over the previous 6 months. HRE-MSM (61%) were more engaged in receptive practices, had a higher proportion of inconsistent condom use during anal sex, and reported more sexual partners than MRE-MSM (39%). The proportion of HIV seroconversions observed during the first 18 months of follow-up using sexual behavioral profiles (92% are HRE-MSM) was higher than using the three risky sexual practices separately. Factors associated with the HRE-MSM profile were being younger (18-21 years), reporting stigma, and having had no female partner while being attracted only to men. Our findings suggest that in order to identify MSM most at risk of HIV infection, several risky sexual practices need to be evaluated in a combined approach. Prevention programs should pay particular attention to younger MSM, and implement activities addressing questions of MSM identity and stigma in order to reduce the dynamic of HIV infection in Western African MSM.

Published
2019
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3. Low Seroprevalence of Hepatitis C Among Men Who Have Sex With Men in West Africa

Author

Mahamadou Diarra, Oumar Cissé, Mamadou Ouedraogo, Niamkey Thomas Aka, Kossi Jeff Yaka, Ter Tiero Elias Dah, Stéphane-Alain Babo Yoro, Honoré Comsiambo, Martine Peeters, Kpassou Julien Lokrou, Daniela Rojas Castro, Bréhima Abdrahamane Ouary, Cyril Berenger, Kokou Dominique Tegueni, Michel Bourrelly, Frédéric Dibi N’guessan, Bintou Dembélé Keita, Ousseni Ilboudo, Adama Cissé, Naboh Sangaré, Aly Ouologuem, Fodié Diallo, Marion Mora, Aléda Mawuli Badjassim, Julien Bimba, Kouakou Kokouvi Selom Agbomadji, Ibrahima Kanta, Gwenvael Le Guicher, Camille Rajaonarivelo, Camille Anoma, Laetitia Serrano, Messan Attiogbe, Luis Sagaon-Teyssier, Alassane Kader Maïga, Clotilde Couderc, Gwenaëlle Maradan, Abdoulazziz Traoré, Issifou Yaya, Bruno Granouillac, Drissa Camara, Anani Attisso, Alou Coulibaly, Jean Armel Ekessi Koffi, Phyllis Amivi Ehlan, Claver Anoumou Yaotsè Dagnra, Anouwarsadat Kokouba, Sayouba Ouedraogo, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Joseph Ouedraogo, Agbégnigan Lorette Ekon, Fodé Traoré, Christian Coulibaly, Abdoul Aziz Keita, Richard Mawuényégan Kouamivi Agboyibor, Ephrem Mensah, Lucas Riegel, Mohamed Mimi, Paméla Palvadeau, Noufo Hamed Coulibaly, Christian Laurent, Fayçal Rodrique Ouedraogo, Issa Traoré, Bruno Spire, Sylvie Boyer, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), ARCAD Santé PLUS [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CohMSM Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Richard Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Yaotsè Dagnra, Phyllis Amivi Ehlan, Kokou Dominique Tegueni, Malbec, Odile, and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)

Subjects
Male, Microbiology (medical), [SDV]Life Sciences [q-bio], MEDLINE, West africa, Men who have sex with men, MESH: Homosexuality, Male, Sexual and Gender Minorities, Seroepidemiologic Studies, MESH: Africa, Western, medicine, Humans, Seroprevalence, Homosexuality, Male, Online Only Articles, ComputingMilieux_MISCELLANEOUS, MESH: Hepatitis C, MESH: Humans, MESH: Seroepidemiologic Studies, business.industry, virus diseases, Hepatitis C, medicine.disease, MESH: Male, MESH: Sexual and Gender Minorities, [SDV] Life Sciences [q-bio], Africa, Western, Infectious Diseases, business, Demography
Abstract

BACKGROUND: Sexual transmission of hepatitis C virus (HCV) is uncommon, yet documented among men who have sex with men (MSM), primarily among those with human immunodeficiency virus (HIV). METHODS: In the HIV Prevention Trials Network 078 study (HPTN 078), which assessed an integrated strategy to achieve HIV viral suppression, 1305 MSM were screened across 4 geographically diverse US cities. At screening, demographic/behavioral/psychosocial questionnaires were completed, along with HIV and HCV testing. Multivariable logistic regression was used to evaluate associations with HCV antibody positivity. RESULTS: Among the 1287 (99%) of the MSM with HCV antibody results, the median age was 41, 69% were black, 85% had a high school education or more, 35% were employed, 70% had HIV, and 21% had undergone substance use counseling. The median lifetime number of male sexual partners was 17 (interquartile range, 6–50), and 246 (19%) were HCV antibody positive. HCV antibody positivity was high in MSM with HIV (20%) and MSM without HIV (17%) (P = .12) and was higher in those receiving substance use counseling (36%) than in those who had not (15%) (P ≤ .01). Substance use counseling (odds ratio, 2.51; 95% confidence interval, 1.80–3.51) and unstable housing (2.16; 1.40–3.33) were associated with HCV antibody positivity. CONCLUSIONS: Nearly 1 in 5 MSM screened for HPTN 078 have been infected with HCV. The prevalence is high regardless of HIV status and is high even in those who did not undergo substance use counseling. In HIV burden networks, high HCV infection prevalence may occur in MSM without HIV. As implementation of preexposure prophylaxis expands and condom use declines, routine HCV counseling and screening among MSM are important.

Published
2021
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4. Transactional sex among men who have sex with men participating in the CohMSM prospective cohort study in West Africa

Author

Michel Bourrelly, Bintou Dembélé Keita, Ephrem Mensah, Camille Anoma, Abdoul Aziz Keita, Pierre-Julien Coulaud, Elias Ter Tiero Dah, Bruno Spire, Cheick Haïballa Kounta, Stéphane-Alain Babo Yoro, Gwenaëlle Maradan, Luis Sagaon-Teyssier, Selom Agbomadji, Clotilde Couderc, Marion Mora, Christian Laurent, Christian Coulibaly, Adeline Bernier, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Centre Muraz [Bobo-Dioulasso, Burkina Faso], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut de Recherche pour le Développement (IRD [France-Sud]), Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montpellier (UM), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), and Aiello, Mélisande

Subjects
RNA viruses, Male, Safe Sex, Epidemiology, Economics, Physiology, [SDV]Life Sciences [q-bio], Social Sciences, HIV Infections, Human sexuality, Pathology and Laboratory Medicine, Men who have sex with men, West africa, Geographical Locations, Cohort Studies, 0302 clinical medicine, Immunodeficiency Viruses, Reproductive Physiology, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Copulation, Medicine and Health Sciences, Medicine, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Generalized estimating equation, Alcohol Consumption, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, 3. Good health, [SDV] Life Sciences [q-bio], Africa, Western, Sexual Partners, Medical Microbiology, HIV epidemiology, Viral Pathogens, Sex life, Viruses, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pathogens, 0305 other medical science, Research Article, Adult, Sexual Behavior, HIV prevention, Men WHO Have Sex with Men, Transactional sex, Microbiology, Young Adult, 03 medical and health sciences, Retroviruses, Humans, Homosexuality, Male, Microbial Pathogens, Socioeconomic status, Nutrition, Preventive medicine, Sex Workers, 030505 public health, business.industry, Lentivirus, Organisms, Biology and Life Sciences, HIV, Diet, Public and occupational health, People and Places, Africa, Population Groupings, business, Finance, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Sexuality Groupings, Demography
Abstract

International audience; Although the HIV epidemic is generalized in West Africa, some population groups such as men who have sex with men (MSM), especially those engaged in transactional sex (TS), are thought to be particularly more vulnerable to HIV than others. However, few data are available to help identify their health-related needs with a view to implementing targeted prevention interventions. To fill this knowledge gap, we aimed to characterize MSM reporting TS (MSM-TS) and to identify factors associated with their sexual practices using data from the prospective cohort study CohMSM, which was conducted in Burkina Faso, Côte d'Ivoire, Mali and Togo. Three stigmatization sub-scores were constructed (experienced, perceived and internalized). The generalized estimating equation method was used for data analysis. Of the total 630 HIV-negative MSM recruited in CohMSM, 463, 410 and 244 had a follow-up visit at 6, 12 and 18 months, respectively. In a total of 1747 follow-up visits, 478 TS encounters were reported by 289 MSM-TS (45.9%). Of the latter, 91 regularly reported TS (31.5%), 55 (19.0%) stopped reporting TS after baseline, and 53 (18.3%) reported TS after baseline and 90 (31.1%) occasionally reported TS. The following variables, regarding the previous 6 months, were positively associated with TS: being younger (aOR[95%CI]:1.86[1.39-2.50]), less educated (aOR[95%CI]:1.49[1.09-2.03]), unmarried status (aOR[95%CI]:1.79[1.10-2.93]), satisfaction with current sex life (aOR[95%CI]:1.41[1.06-1.88]), group sex with men (aOR[95%CI]:2.07[1.46-2.94]), multiple male sexual partners (aOR[95%CI]:1.85[1.40-2.44]), receptive or versatile anal sex with male partners (aOR [95%CI]:1.48[1.12-1.96]), giving benefits in exchange for sex with a man (aOR[95%CI]:2.80[1.97-3.98]), alcohol consumption (aOR[95%CI]:1.44[1.08-1.93]) and drug use (aOR[95%CI]:1.82[1.24-2.68]) during sex, and finally experiencing stigmatization (aOR [95%CI]:1.15[1.07-1.25]). Condom use during anal sex (aOR[95%CI]:0.73[0.53-0.99]) was negatively associated with TS.

Published
2019
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5. Male clients of male sex workers in West Africa: A neglected high-risk population

Author

Cheick Haïballa Kounta, Luis Sagaon-Teyssier, Pierre-Julien Coulaud, Marion Mora, Gwenaelle Maradan, Michel Bourrelly, Abdoul Aziz Keita, Stéphane-Alain Babo Yoro, Camille Anoma, Christian Coulibaly, Elias Ter Tiero Dah, Selom Agbomadji, Ephrem Mensah, Adeline Bernier, Clotilde Couderc, Bintou Dembélé Keita, Christian Laurent, Bruno Spire, CohMSM Study Group, Institut National de la Santé et de la Recherche Médicale (INSERM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut de Recherche pour le Développement (IRD [France-Sud]), Université de Montpellier (UM), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), and Aiello, Mélisande

Subjects
RNA viruses, Male, Bisexuals, [SDV]Life Sciences [q-bio], Human sexuality, HIV Infections, 030312 virology, Logistic regression, Pathology and Laboratory Medicine, Mali, Men who have sex with men, Geographical Locations, Sexual and Gender Minorities, 0302 clinical medicine, Immunodeficiency Viruses, Risk Factors, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Homosexuality, Young adult, Male Sex Workers, Prospective cohort study, media_common, 0303 health sciences, education.field_of_study, Multidisciplinary, Middle Aged, [SDV] Life Sciences [q-bio], Professions, Medical Microbiology, Viral Pathogens, Viruses, Infectious diseases, Pathogens, Research Article, Adult, Science, media_common.quotation_subject, Sexual Behavior, Population, HIV prevention, Men WHO Have Sex with Men, Transactional sex, Viral diseases, Microbiology, 03 medical and health sciences, Young Adult, Retroviruses, Burkina Faso, Humans, Homosexuality, Male, education, Microbial Pathogens, Preventive medicine, Sex Workers, business.industry, Lentivirus, Organisms, Biology and Life Sciences, HIV, Public and occupational health, Logistic Models, People and Places, Africa, Population Groupings, business, Demography, Sexuality Groupings
Abstract

International audience; Research on male clients of male sex workers (MCMSW) has been neglected for a long time globally. We aimed to characterize MCMSW and to identify factors associated with their sexual practices using data from the prospective cohort study CohMSM conducted in Burkina Faso, Côte d'Ivoire, Mali and Togo. Our study focused on HIV-negative men who have sex with other men (MSM), recruited between 06/2015 and 01/2018 by a team of trained peer educators. Scheduled study visits at 6, 12 and 18 months included medical examinations, HIV screening, risk-reduction counselling and face-to-face interviews to collect information on their sociodemographic characteristics, sexual behaviours, and HIV risk-reduction strategies (HIV-RRS). Three stigmatization sub-scores were constructed (experienced, perceived and internalized). Mixed-effects logistic regression was used for data analysis. Of the 280 participants recruited at baseline, 238, 211 and 118, respectively, had a follow-up visit at 6, 12 and 18 months. Over a total of 847 visits, 47 transactional sex (TS) encounters were reported by 38 MCMSW (13.6%). Of the latter, only one participant reported systematic TS (2.6%), 18 (47.4%) stopped reporting TS after baseline, while 6 (15.8%) reported TS after baseline. Thirteen participants (34.2%) reported occasional TS. After adjusting for country of study and age, the following self-reported factors were associated with a greater likelihood of being MCMSW: protected anal sex, exclusively insertive anal sex with male sexual partners, avoidance of sex after consuming psychoactive products and experiencing stigmatization (all during the previous 6 months). The majority of MCMSW in this study practiced HIV-RRS with male sexual partners, including engaging in protected anal sex, avoidance of sex when consuming psychoactive products, and practising exclusively insertive anal sex.

Published
2019
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6. Interest in HIV pre-exposure prophylaxis in men who have sex with men in West Africa (CohMSM ANRS 12324 - Expertise France)

Author

Pierre-Julien, Coulaud, Luis, Sagaon-Teyssier, Bakridine, M'madi Mrenda, Gwenaëlle, Maradan, Marion, Mora, Michel, Bourrelly, Bintou, Dembélé Keita, Abdoul Aziz, Keita, Camille, Anoma, Stéphane-Alain, Babo Yoro, Ter Tiero Elias, Dah, Christian, Coulibaly, Ephrem, Mensah, Selom, Agbomadji, Adeline, Bernier, Clotilde, Couderc, Christian, Laurent, Bruno, Spire, Claver Anoumou Yaotsè, Dagnra, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), ARCAD-SIDA [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Coalition PLUS [Pantin, France], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), This study was funded by the ANRS (France Recherche Nord & Sud Sida-hiv Hépatites, ANRS 12324) and Expertise France (Initiative 5%). PJC was the recipient of a doctoral fellowship from ANRS (B7-ANRS 12324)., The CohMSM Study Group : Granouillac B, Izard S, March L, Peeters M, Serrano L, Berenger C, Parisi E, Palvadeau P, Rojas Castro D, Trenado E, Camara D, Cisse O, Coulibaly A, Diallo F, Diarra M, Gadjigo M, Maiga K, Ouologuem A, Traore F, Aka NT, Coulibaly NH, Kotchi R, Kouabenan P, Kouame MJ, Lokrou KJ, N'Guessan FD, Anglaret X, Masumbuko JM, Oga M, Ilboudo O, Ouedraogo J, Ouedraogo M, Thio E, Toure JR, Traore A, Traore I, Yougbare F, Meda N, Agboyibor RMK, Attiogbe M, Badjassim AM, Ekon AL, Kokouba A, Tablissi DJS, Yaka KJ, Dagnra CAY., Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Dupuis, Christine, and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)

Subjects
Adult, Male, Health Knowledge, Attitudes, Practice, Anti-HIV Agents, Human immunodeficiency virus (HIV), men who have sex with men, HIV Infections, Transactional sex, Mali, medicine.disease_cause, Logistic regression, Men who have sex with men, Sexual and Gender Minorities, Young Adult, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, prevention, Burkina Faso, medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, pre-exposure prophylaxis, 030505 public health, Unsafe Sex, business.industry, Public Health, Environmental and Occupational Health, HIV, Odds ratio, Patient Acceptance of Health Care, Confidence interval, 3. Good health, Cote d'Ivoire, Cross-Sectional Studies, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Togo, Africa, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, prophylaxis, 0305 other medical science, business, Demography, Cohort study
Abstract

International audience; OBJECTIVE:To explore the interest in taking PrEP among Western African men who have sex with men (MSM).METHODS:A cross-sectional survey was implemented at enrolment of HIV-negative MSM in a multiple centre community-based cohort study in four West African countries (Mali, Côte d'Ivoire, Burkina Faso, Togo). A standardised face-to-face questionnaire collected data on socio-demographic and behavioural characteristics over the previous 6 months. Descriptive analysis and multivariate logistic regression helped identify factors associated with the interest in taking PrEP.RESULTS:Of 564 participants, 87% were interested in taking PrEP. Interest in PrEP was associated with inconsistent condom use for anal sex (adjusted odds ratio (aOR): 2.11; 95% confidence interval (CI) 1.21-3.67), transactional sex (aOR: 2.02; 95% CI 1.11-3.71), searching for male sexual partners on the Internet in the previous month (aOR: 1.86; 95% CI 1.01-3.43), having a high level of self-esteem (aOR: 1.20; 95% CI 1.06-1.36), having at least one sexually transmitted infections at enrolment (aOR: 5.08; 95% CI 1.40-18.4) and not being aware of PrEP (aOR: 2.03; 95% CI 1.04-3.96). Participants having sex with HIV-positive male partners (aOR: 0.28; 95% CI 0.11-0.74), those being more sexually attracted to women than to men (aOR: 0.20; 95% CI 0.07-0.89) and those reporting psychological and material support from close friends (aOR: 0.33; 95% CI 0.15-0.73) were less interested in taking PreP.CONCLUSIONS:Western African HIV-negative MSM appear very interested in taking PrEP, especially those most at risk of HIV infection. PrEP implementation in a comprehensive prevention package should be considered urgently.

Published
2018
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7. Heterogeneity in the Prevalence of High-Risk Human Papillomavirus Infection in Human Immunodeficiency Virus-Negative and Human Immunodeficiency Virus-Positive Men Who Have Sex With Men in West Africa

Author

Issifou, Yaya, Véronique, Boyer, Phyllis Amivi, Ehlan, Alou, Coulibaly, Mawuényégan Kouamivi, Agboyibor, Issa, Traoré, Malan Jean-Baptiste, Kouamé, Alassane Kader, Maiga, Ochoh Rachelle, Kotchi, Yawo Tufa, Nyasenu, Gwenaëlle, Maradan, Daniela, Rojas-Castro, Fodié, Diallo, Camille, Anoma, Ter Tiero Elias, Dah, Ephrem, Mensah, Bintou, Dembélé Keita, Bruno, Spire, Claver Anoumou, Dagnra, Christian, Laurent, Kokou Dominique, Tegueni, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Lomé [Togo], ARCAD Santé PLUS [Bamako, Mali], Espoir Vie Togo [Lomé, Togo], Association African Solidarité [Ouagadougou, Burkina Faso], Espace Confiance [Abidjan, Côte d’Ivoire], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition PLUS [Pantin, France], CohMSM Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Richard Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Yaotsè Dagnra, Phyllis Amivi Ehlan, Xavier Yawo Tufa Nyasenu, Kokou Dominique Tegueni., Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), and Dupuis, Christine

Subjects
Male, Microbiology (medical), HPV, Multivariate analysis, Adolescent, [SDV]Life Sciences [q-bio], MSM, Human immunodeficiency virus (HIV), Anal Canal, HIV Infections, Logistic regression, medicine.disease_cause, Men who have sex with men, Sexual and Gender Minorities, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Burkina Faso, Prevalence, medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, Papillomaviridae, business.industry, Papillomavirus Infections, HPV infection, HIV, virus diseases, Odds ratio, medicine.disease, Confidence interval, [SDV] Life Sciences [q-bio], Vaccination, Cross-Sectional Studies, Infectious Diseases, 030220 oncology & carcinogenesis, Africa, Female, business, Demography
Abstract

Background Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection. We assessed (i) the prevalence of high-risk HPV (HR-HPV) infection and associated factors, and (ii) the prevalence of vaccine-preventable HPV infections in MSM in Burkina Faso, Côte d’Ivoire, Mali, and Togo. Methods A cross-sectional study was conducted in 2017–2018 among MSM ≥18 years old followed in community-based clinics. HPV infection was investigated in oral and anal samples using the e-BRID system. Factors associated with HR-HPV infection were identified using multivariate logistic regressions. Results Among 631 participants, 425 were HIV-negative and 206 HIV-positive. HR-HPV prevalence ranged from 9.2% to 34.8% in the former, and 33.3% to 71.0% in the latter, according to the study country. In multivariate analysis, HIV infection (adjusted odds ratio (aOR) 3.61, 95% confidence interval (CI) 2.48–5.27) and study country (4.73, 2.66–8.43 for Mali; 3.12, 1.68–5.80 for Burkina Faso; 3.51, 1.92–6.42 for Togo) were associated with HR-HPV infection. Other associated factors were low educational level, self-defined homosexual identity, and condomless anal sex. The prevalence of infections which can be prevented with bivalent, quadrivalent, and nonavalent vaccines was 5.9, 27.1, and 34.6% in HIV-negative participants, and 18.9, 43.7, and 54.9% in HIV-positive participants, respectively. Conclusions HR-HPV prevalence was very heterogeneous between the study countries in both HIV-negative and HIV-positive MSM. Vaccine-preventable HPV infections predominated. Vaccination should be proposed to young MSM to reduce the burden of HPV infection in this vulnerable population and their female partners in West Africa.

Published
2021
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8. Socio-behavioral correlates of pre-exposure prophylaxis use and correct adherence in men who have sex with men in West Africa

Author

August, Eubanks, Bakary, Coulibaly, Bintou, Dembélé Keita, Camille, Anoma, Ter Tiero Elias, Dah, Ephrem, Mensah, Sékou, Kaba, Kpassou Julien, Lokrou, Faïçal Rodrigue, Ouedraogo, Alèda M Fidèle, Badjassim, Gwenaëlle, Maradan, Michel, Bourrelly, Marion, Mora, Lucas, Riegel, Daniela, Rojas Castro, Issifou, Yaya, Bruno, Spire, Christian, Laurent, Luis, Sagaon-Teyssier, Claver Anoumou Yaotsè, Dagnra, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), ARCAD Santé PLUS [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Association African Solidarité [Ouagadougou, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Coalition PLUS [Pantin, France], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and CohMSM-PrEP Study Group: Sayouba Ouedraogo, Bruno Granouillac, Laetitia Serrano, Martine Peeters, Cyril Berenger, Marion Fiorentino, Paméla Palvadeau, Bea Vuylsteke, Irith De Baetselier, Thijs Reyniers, Tania Crucitti, Fodié Diallo, Alou Coulibaly, Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Abdoul Aziz Keita, Fodé Traoré, Oumar Cissé, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Malan Jean-Baptiste Kouame, Rachelle Kotchi, Niamkey Thomas Aka, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Issa Traoré, Camille Rajaonarivelo, Joseph Ouedraogo, Juste Rodrigue Touré, Christian Coulibaly, Mamadou Ouedraogo, Elisabeth Thio, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Richard Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Yaotsè Dagnra.

Subjects
Male, West Africa, Anti-HIV Agents, Sexual Behavior, [SDV]Life Sciences [q-bio], HIV, HIV Infections, PrEP, Medication Adherence, Sexual and Gender Minorities, Community-based research, Burkina Faso, Humans, Pre-Exposure Prophylaxis, MSM, Homosexuality, Male
Abstract

BackgroundMultiple barriers compromise pre-exposure prophylaxis (PrEP) engagement (i.e., use and adherence) in men who have sex with men (MSM). In low/middle-income countries, little is known about PrEP engagement in this population. In West Africa, the CohMSM-PrEP study was one of the rare interventions providing PrEP to MSM. We estimated PrEP use and correct adherence rates in CohMSM-PrEP, together with associated factors.MethodsCohMSM-PrEP recruited MSM in four community-based clinics in Mali, Côte d’Ivoire, Burkina Faso, and Togo. Quarterly follow-up included collecting socio-behavioral data, and providing a comprehensive HIV prevention package, PrEP (daily or event-driven), and peer educator (PE)-led counselling (prevention and adherence). Multivariate generalized estimating equations (GEE) models were used to identify factors associated with self-reported i) PrEP use and ii) correct PrEP adherence during participants’ most recent anal intercourse.Results520 participants were retained for the present analysis. Median follow-up time was 12 months (IQR 6-21). Of the 2839 most recent anal intercourses declared over the follow-up period, PrEP use was self-reported for 1996 (70%), and correct PrEP adherence for 1461 (73%) of the latter. PrEP use was higher in participants who attended participating clinics outside of scheduled visits (adjusted odds ratio (aOR) [95% Confidence Interval, CI], p-value; 1.32 [1.01-1.71], 0.040), and in those who practiced condomless anal sex (1.86 [1.54-2.24], ConclusionsCommunity-based clinic attendance and PE contact outside of scheduled visits were both associated with higher PrEP engagement. Some socially and economically marginalized participants struggled with adherence. Providing adherence support is crucial for PrEP effectiveness, especially in hostile sociocultural contexts. As PrEP scale-up continues in West Africa, we recommend using comprehensive community-based interventions to ensure adequate PrEP engagement.

Published
2022
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